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인지운동치료가 뇌졸중 환자의 체간 기능 및 체중 분배에 미치는 영향
김상걸(Sang Geol Kim),이경록(Kyung Rok Lee),정원미(Won Mee Jeong) 한국인지운동치료연구회 2011 한국신경인지재활치료학회지 Vol.3 No.1
Objective : It is intended to investigate the effect of cognitive therapeutic exercise for body core of apoplexy patient on body core function and weight distribution. Methods : Subjects of the study were 8 apoplexy patients within 1 year after attack of the disease, and were divided into the group(4 persons) that general treatment was carried out, and group(4 persons) that cognitive therapeutic exercise was carried out, and cognitive therapeutic exercise was applied to body core 30 minutes a time a day for 4 weeks from October 31 to November 25 2011. In evaluation of body core, static balance, dynamic balance, and coordination was evaluated by using Trunk Impairment Scale(TIS) in a sitting position, and weight distribution was measured by using 2 scales in a sitting position and stand-up position for capability of weight distribution. Results : Reevaluated results 4 weeks after initial evaluation showed statistically significant improvement in evaluation of body core function through TIS(p<.00). Weight distribution showed significant difference in both sitting position and stand-up position in reevaluation of weight distribution by using the scales. Conclusion : When cognitive therapeutic exercise was applied to body core, it had an effect on the improvement of body core function and weight distribution of apoplexy patients.
연구논문 : 재정비촉진지구내 원주민의 가구적 특성과 재정착 의사 -대구광역시 동구 재정비촉진지구를 사례로-
김상걸 ( Sang Geol Kim ),이성근 ( Seong Geun Lee ) 영남대학교 한국균형발전연구소 (구 영남대학교 영남지역발전연구소) 2009 한국지역혁신논집 Vol.4 No.3
본 연구는 재정비촉진지구내 원주민의 가구적 특성과 재정착 의사를 조사분석하고자 하였다. 이를 위해 2007년 재정비촉진지구로 지정된 대구시 동구 재정비촉진지구를 대상으로 원주민을 소유자와 세입자로 구분하여 2009년 4월 27일부터 5월 5일까지 9일간 각각 100부씩의 설문조사를 실시하였으며, 조사된 결과의 분석은 SPSS 통계프로그램을 활용하여 처리하였다. 분석된 결과를 요약하면 먼저 원주민의 가구적 특성으로는 50대 이상의 고령인구비율이 높고, 10년 미만의 거주기간에 주로 자영업을 통해 생계를 유지하고 있으며, 주이용 교통수단은 승용차와 버스인 것으로 조사되었다. 다음으로 재정착 의사와 관련해서는 정주희망지역으로 재정비촉진지구내가 가장 높았으며, 향후 주거대책 및 계획에 대해서는 소유자의 경우는 조합원 아파트에 입주, 세입자의 경우는 세입자용 공공아파트 입주권과 이주대책비가 비슷한 양상을 보였으며, 개발기간 동안 거주 계획에 대해서는 같은 구(같은 동)에 거주하겠다는 응답이 가장 많았다. 이상의 분석결과를 가지고 원주민의 재정착을 높이기 위한 방안으로 소득수준을 고려한 임대주택의 임대료산정, 임대주택 및 소형평형의무설치 비율의 적절한 조절, 임대주택의 다양한 평면개발, 공공부문의 적극적인 참여 및 커뮤니티 형성을 위한 통합된 단지설계를 제시하였다. This study tried to investigate and analyze the characteristics of households and re-settlement intention concerning residents in reorganization promotion zone. For that, as for the reorganization promotion zone in Dong-gu Daegu that was designated as the reorganization promotion zone in 2007, the residents were divided into owners and tenants to whom 100 questionnaires were administered respectively for 9 days from April 27 to May 5, 2009. The investigated results were treated and analyzed using SPSS statistic program. The summary of investigated results showed that the households of residents were characterized by high rate of the aged population over 50s, dwelling period was less than 10 years, mostly self-employed business was done for living and main transportation means were car and bus. As for re-settlement intention, most preferred desirable region to settle was inside the reorganization promotion zone. As for afterwards dwelling measure and plan, owners were supposed to move in association member`s apartment house and tenants prepared the right to move in public apartment house and countermeasure expenditure for moving in a similar rate. As for the dwelling plan for the period of development, the highest rate answered to dwell in the same gu(dong). To raise the re-settlement rate of residents with above result of analysis, required are the estimation of rent of rental house considering the level of income, proper adjustment of the rate of rental house and small lot mandatory establishment, development of various plane of rental house, active participation by public sector and integrated design of complex to form the community.
5 ㎝ 이하의 간세포암에 대한 제한적 간절제술과 대량간절제술후 결과 및 장기 생존율 비교
김혜진(Hye Jin Kim),황윤진(Yoon Jin Hwang),김종렬(Jong Yeol Kim),권형준(Hyung Jun Kwon),김규성(Gyu Sung Kim),천재민(Jae Min Chun),김상걸(Sang Geol Kim),윤영국(Young Kook Yun) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.1
Purpose: Though major hepatic resections including hemihepatectomy, trisectionectomy, and central bisectionectomy are most commonly employed for small (<5 ㎝) hepatocellular carcinoma (HCC), limited hepatic resection is indicated in some HCC patients with impaired liver function, poor physical condition, or tumors peripherally located. We compared the clinicopathological features and long-term survival between the patients who underwent major resection and limited resection. Methods: From January 1998 to May 2007, 223 patients who underwent hepatic resection for small HCC were enrolled. 123 patients underwent limited resection and 100 patients underwent major resection. Clinocopathologic features, overall, and disease-free survival were compared between both groups. Results: The limited resection group had lower mean serum albumin levels (3.86±0.41 vs. 4.11±3.61, P<0.0001) and higher mean ICG R15 (12.66±0.87 vs. 7.51±4.33, P<0.0001). Patients with esophageal varix and liver cirrhosis were more common in the limited resection group (34.1% and 73.1% versus 9% and 45% respectively). Morbidity and mortality were not different in both groups. Overall 1-, 3-, 5-year survivals in both limited resection and major resection groups were 89.4%, 77.3%, 43.8% and 87.8%, 76.5%, 62.1% respectively (P=0.161) and 1-, 3-, 5-year disease free survivals were 80.2%, 50.2%, 38.6% and 79.9%, 63.2%, 50.4% respectively (P=0.10). Conclusion: Despite indifference of overall and disease-free 5-year survival rates between limited and major resection groups, careful follow up is essential to detect late recurrence in the limited resection group, since limited resection tends to have more frequent recurrence, especially 2 years after surgery.
비신생물성 질환에 대한 췌십이지장 절제술의 안정성 및 수술 후 삶의 질에 대한 평가
은영아(Young A Eun),김상걸(Sang Geol Kim),윤혁진(Hyuk Jin Yun),김종렬(Jong Yeol Kim),김갑철(Gab Chul Kim),염현규(Hyun Kyu Ryeom),김성희(Sung Hi Kim),황윤진(Yun Jin Hwang),윤영국(Young Kook Yun) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.1
Purpose: Pancreaticoduodenectomy for mass-like lesions that are suspicious of malignancy sometimes reveals only nonneoplastic disease, especially in those cases where adequate tissues for biopsy are unavailable. In this study, we evaluated the outcomes and quality of life (QOL) after pancreaticoduodenectomy for treating nonneoplastic disease. Methods: The clinical data of 28 patients who underwent pancreaticoduodenectomy for nonneoplatic disease and trauma from Jan. 1992 to Feb. 2006 were reviewed retrospectively. The QOL was evaluated using the FACT-Hep questionnaire. The patients who underwent laparoscopic cholecystectomy for benign gallbladder disease were utilized as the control group. Results: 13.8% (28/203) of all the pancreaticoduodenectomized patients had nonneoplatic disease and trauma. Male patients were predominant (25/28) and all the trauma patients were male. The mean age was 48 (23∼72) years old. The indications for surgery included lesions suspicious for malignancy (16 cases), pancreaticoduodenal artery aneurysm (1 case), and pancreatoduodenal injury (11 cases). The histologic findings of the nonneoplastic lesions revealed benign inflammation of the bile duct (6 cases), chronic pancreatitis (8 cases), pancreatic pseudocyst (1 case), and fibrosis of the Ampulla of Vater (1 case). No surgical mortality occurred. However, the trauma patients group had higher morbidity (72.7% Vs 23.5%, respectively, P=0.01) and a longer hospital stay (68.0 days Vs 32.6 days, respectively, P=0.02) after surgery compared to the nonneoplastic disease patient group. The QOL of the patient who underwent pancreaticoduodenectomy for nonneoplatic disease was not different from that of the control group. Conclusion: Since pancreaticoduodenectomy for nonneoplastic disease was safe and the QOL of the patients was acceptable, it should be performed more often when malignancies can not be excluded from the differential diagnosis.
조자윤(Ja Yun Cho),김종열(Jong Yeol Kim),장수근(Su Kurn Chang),김상걸(Sang Geol Kim),황윤진(Yoon Jin Hwang),윤영국(Young Kook Yun) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.4
Purpose: Biliary tract disease is one of the most common causes of acute abdominal pain in elderly patients, but there is still some debate over treatment. The aim of this study is to determine the safety and surgical outcomes of laparoscopic cholecystectomy (LC) for benign gallbladder disease in octogenarian patients. Methods: We selected 42 patients of 80 years or older who underwent LC or open-converted cholecystectomy(OC) from February 1992 to November 2006. We evaluated clinicopathological features, treatment modalities, and surgical outcomes retrospectively. Results: The patients included 17 males and 25 females. The mean age of the patients was 83.3 and 83.7, respectively. Right upper quadrant pain was the most common symptom, present in 85.7% of the patients. Gallstones were present in 85.7%. ASA class Ⅱ and Ⅲ comprised 92.9% of the patients. Comorbidities included hypertension, cardiac disease, pulmonary disease, and diabetes mellitus. Preoperatively biliary drainage was performed in 12 cases (endoscopic drainage in 8, percutaneous drainage in 4 cases). Preoperative cholecystostomy was performed in 5 cases. Emergency operations were more frequent than elective surgery (25 vs. 17). Mean hospital stay of LC patients was 5 days, whereas that of OC patients was 13 days. Open conversion rate was 16.7%. No surgical mortality was present and postoperative morbidity included acute myocardial infarction in one patient and wound infection in one patient. Conclusion: LC in octogenarian patients was safe. However, since the incidence of comorbidities is high in these patients, great care should be taken to evaluate and manage the comorbidities before surgery.
황윤진(Yoon Jin Hwang),김종열(Jong Yeol Kim),장수근(Su Kurn Chang),김상걸(Sang Geol Kim),김양일(Yang Il Kim),황정현(Jeong Hyun Hwang) 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.1
Purpose: Acute fulminant hepatic failure (FHF) is associated with high mortality. Recent studies have shown that a liver support system based on viable hepatocytes can prolong life in animal models of FHF and also in some FHF patients who were successfully bridged to liver transplantation. To be applied in humans, the bioartificial liver (BAL) system should have sufficient liver cell mass to provide adequate bioactive support. The most widely investigated bioreactor at present is based on hollow fiber membrane. However, it is difficult to build a scaledup module of this model. We devised a fluidized-bed bioreactor that is packed with isolated porcine hepatocytes, and these hepatcytes are immobilized in Ca-alginate hydrogel. Methods: We isolated fresh porcine hepatocytes using a 2-step collagenase perfusion method, and they were suspended in 1.5% alginate solution. Through a drop-generator, this mixture was gelled in 135mM Cacl2. The resulting spherical beads (mean size: 500 m) were embedded in a module. An average of 2x1010 hepatocytes were present in the module. The efficacy of our design was tested in pigs that had undergone total hepatic devascularization and portocaval shunt. Results: The BAL-treated group showed a significantly lower ammonium build-up rate compared to the control group (598.6±344.2 g/dl vs 1937.6±744.1 g/dl, respectively, at 8 hours after connecting to BAL). In addition, the intracranial pressure was well controlled in the BAL-treated group, whereas the control group showed a progressive increase of the intracranial pressure (16.9±1mmH2O vs 21.9±2.6mmH2O, respectively, at 8 hours after connecting to BAL). Conclusion: Our bioartificial liver system is a fluidized-bed bioreactor packed with immobilized porcine hepatocytes, and it seems to be a more effective scaled-up module.